Laparoscopic management of pediatric renal and ureteric stones

To assess the feasibility of laparoscopy in the treatment of pediatric urolithiasis, we report our experience with the transperitoneal laparoscopic removal of stones.

Renal pelvic stones of size ≥1 cm on ultrasound were included for laparoscopic pyelolithotomy while smaller stones were managed with shock-wave lithotripsy monotherapy. Intrarenal stones, calyceal stones, complete staghorn stones, multiple stones and kidneys with intrarenal pelvis were excluded. Ureteric stones included for laparoscopic ureterolithotomy were of size ≥1 cm in the upper, mid or lower ureter, and smaller stones not responding to non-operative treatment.

A total of 22 procedures were performed: 12 pyelolithotomies, and 8 lower and 2 upper ureterolithotomies. Complete removal of calculi was accomplished in 21 (95.45%) procedures. Complications associated with laparoscopic lithotomy included urinoma (4.54%), failure (4.54%) and omental prolapse (4.54%).

Laparoscopic lithotomy is safe and feasible in pediatric urolithiasis with pyelic and ureteric stones, with minimal complications and failure rate.